Replies to This Discussion

Permalink Reply by Kelleigh on November 26, 2012 at 7:46pm

I had this same problem for the first 3 days. They for whatever reason started my basal rate too high. I imagine you are experiencing the same. These doctors should always start conservatively! I take .55 units per hour. I take .65 units from midnight to 6 am. Seems I need more when sleeping. Good luck with the omni. Once the adjustments are made you should be fine. After 25 years with diabetes and taking numerous shots per day, I do believe omni is much better than shots. But be patient with yourself. It took me nearly 2 months to get comfortable with it. My last A1c was much better (6.6 down from 7.8). Things are getting better each day!

Permalink Reply by HPNpilot on November 26, 2012 at 8:26pm

The first few days are not typical, for whatever reason. My CDE cut my basal *way* back from what I was using on Lantus to prevent this problem. I was upset and worried I would run too high....in fact it was OK, and over the next 2 -3 days I had to crank the basal back up. The Lantus doesn't run out all at once in 24 hours - some may hang around - and absorbtion is different on the pump than on MDI.

Be patient... it may take a month to get all the rates and ratios tuned in. But when it is done you will find your control is much more stable and predictable and in 3 months you will see your A1C coming down.

Permalink Reply by Alisonisayoshi on November 26, 2012 at 11:48pm

Spent my entire first week dialing back my basals and shaking and then going high, dialed the basal down a ton and got way better!

Permalink Reply by Jorge on November 27, 2012 at 5:06am

Different people will react differently to the initial Omni setup. I believe they (technicans that give you the initial training) calculate the total amout of insulin you are using daily, reduce it by a factor (.85 or 85% in my case) and then halve it for the basal level (so, 20 / 24 hr for me.) What happens is that depending on your activity level, this may not be appropriate. I for example bolus much more than 50% my daily insulin, I excercise and am generally active, but there was no way to account for this prior to the training because i would often skip injecting for small snacks before and just correct at meal-time. So while I knew how much insulin I would need for each of my 3 meals provided I stated at about 100 bg, I could not accout for the corrections.

Setting the right levels for the Omnipod is a process of trial and error, I believe it is a process that works well for me as it has made me check my bg more often and explore for trends and effects of excercise and other activities. I have learned for example that while my basal is usually around 0.6 when I am excercising (if I have excercised within the last day and a half) if I have not hit the pool or ran in more than 3 days my basal is 0.8. It seems a lot, but is something I would never figure out with Lantus. As of late, unless it is in the middle of the night, I always suspend insulin for 30 mins to an hour during lows (which is what a healthy pancreas would do) and try to make note of what I ate last time I bolused. Not all carbs are made equal, Cheerios vs Multi-Grain Cheerios, same portion size, only 2 gr carb difference per portion, about 2 whole insulin units difference for me.

I know this is a long reply, but I just wish you luck and hope that my experience somehow gives you a bit of hope that things will be better.

To track foods I have been using the LoseIt app, helps me go back and check what I have eaten and correlate with lows/highs at a later time.

Permalink Reply by Scott Wilkins on November 27, 2012 at 5:40am

With any pump, the transition time is rocky. My Endo's office had me call them daily with reports and they made adjustments every day. Plus there's a learning curve that I and I think most have to go through to understand how different pump control is over MDI. It's very different. Personally, I think it's a little bit more work than MDI but the results eventually pay off for that extra effort.

Permalink Reply by Eric Rizzo on November 27, 2012 at 7:12am

Did you get training by an Omni Pod specialist (CDE)? As others have said, they have specific formulas for figuring your initial basal rate(s) and IC ratio(s); if yours was calculated by an endo who isn't specifically familiar with Omni Pod, it's likely that your basal is too high.
I'm no doctor or CDE, but my injection quantities weren't far from yours when I started OmniPod, but my initial basal rate was a LOT lower than 1.2. Just to give you an idea, my total daily insulin when I started pumping was about 1/3 what I had been taking with injections.

Permalink Reply by Black Llama on November 27, 2012 at 6:50pm

Yeah, I went through the initial training, but my docs office has since replaced the person that did it. She was very hands off and wasn't generally liked by many. I have an appointment with the new nurse/nutritionist Monday. When the did the initial basal, they looked at an average week's worth of data (lantus and novo doses) and just used some basic math calculations to arrive at 1.24 or the 1.2 that I started at. We'll see how it goes on Monday after I go in. Still not feeling great today after yesterdays hellishness.

Thanks all for the replies though :D